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BackTable / ENT / Podcast / Episode #159
Eustachian Tube Dilation In The Pediatric Population
with Dr. Dennis Poe
In this episode, host Dr. Ashley Agan discusses eustachian tube (ET) dilation with Dr. Dennis Poe, neurotologist and Professor of Otolaryngology at Harvard Medical School.
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BackTable, LLC (Producer). (2024, February 20). Ep. 159 – Eustachian Tube Dilation In The Pediatric Population [Audio podcast]. Retrieved from https://www.backtable.com
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Podcast Contributors
Dr. Dennis Poe
Dr. Dennis Poe is an Associate in the Department of Otolaryngology and Communication Enhancement at Boston Children's Hospital, specializing in heotology/neurotology and skull base surgery.
Dr. Ashley Agan
Dr. Ashley Agan is an otolaryngologist in Dallas, TX.
Synopsis
First, the surgeons describe clinically meaningful differences between adult and pediatric ETs. Then, Dr. Poe reviews workup of pediatric ET disorders. Since inflammation accounts for most ET dysfunction, controlling comorbid allergies and/or performing adenoidectomy provides relief to some patients. For patients with continued symptoms, balloon dilation – now approved for children as young as eight years of age– directly counteracts obstructive inflammation in the tube lumen. To conclude, Dr. Poe describes how to select patients for, perform, and avoid complications of balloon dilation.
Timestamps
00:00 - Introduction
04:03 - Understanding Eustachian Tube Anatomy
07:22 - Causes of Eustachian Tube Dysfunction in Children
12:53 - Examination and Diagnosis of Eustachian Tube Dysfunction
19:10 - Treatment Options for Eustachian Tube Dysfunction
27:05 - Avoiding Unpredictable Injury and Scarring During Balloon Dilation
31:51 - Contraindications and Precautions for Balloon Dilation
37:49 - Understanding Risks & Complications of Balloon Dilation
48:34 - Closing Remarks & Future Prospects
Resources
Dr. Dennis Poe’s Harvard Profile:
https://oto.hms.harvard.edu/people/dennis-poe
BackTable ENT Ep. 40 – “Diagnosis & Management of Eustachian Tube Disorders with Dr. Dennis Poe:”
https://www.backtable.com/shows/ent/podcasts/40/diagnosis-management-of-eustachian-tube-disorders
American Academy of Otolaryngology-Head and Neck Surgery Clinical Practice Guideline: Otitis Media with Effusion (Update):
https://www.entnet.org/quality-practice/quality-products/clinical-practice-guidelines/ome/
“Complications of Eustachian Tube Balloon Dilation: Manufacturer and User Facility Device Experience (MAUDE) Database Analysis and Literature Review,” Chisolm, P.F. et al: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10731503/
Transcript Preview
[Dr. Dennis Poe]
Hopefully, and we've got a couple studies that have been showing this, if you do a balloon, your chances of needing further tubes is significantly reduced. That's one thing to consider. Because you're treating the source, you may be reducing the chance of needing further tubes. If I see a child who's had multiple tubes, first of all, I've got to make sure they weren't patulous. Once we've ruled that out, then yes, then I will favor a balloon over multiple tubes. Absolutely. With multiple tubes, as you know, the tympanic membrane can eventually start to break down. Then you're dealing with a thin portion. It might turn into a pocket in the future or they get perforations.
ACCLARENT AERA® Eustachian Tube Balloon Dilation System is intended for use by physicians who are trained on Acclarent Technology. Eustachian tube balloon dilation has associated risks, including tissue and mucosal trauma, infection, or possible carotid artery injury. Prior to use, it is important to read the Instructions for Use and to understand the contraindications, warnings, and precautions associated with these devices.
Caution: Federal (US) law restricts the sale, distribution, or use of these devices to, by or on the order of a physician. Third party trademarks used herein are trademarks of their respective owners. This content is intended for audience within the US only.
This podcast is sponsored by Acclarent, Inc. The information contained in this podcast, and findings and conclusions expressed are those reached independently by the authors.
AMP number US_ACC_AENT_304345
Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.
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